Provider Demographics
NPI:1144756586
Name:KING, TONYA (ARNP)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:
Other - Last Name:KING-CHARLTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10272 LANCASHIRE DR E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32219
Mailing Address - Country:US
Mailing Address - Phone:904-607-9794
Mailing Address - Fax:
Practice Address - Street 1:6150 METROWEST BLVD
Practice Address - Street 2:103
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-3289
Practice Address - Country:US
Practice Address - Phone:407-730-3837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9228884363LF0000X
FLAPRN9228884363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily